The problem of overuse, unnecessary care, or “low value” care is increasingly a focus of the national health policy conversation. Estimates suggest that as much as one-third of health care spending in the United States is of low value. Many factors contribute to the problem, including increased patient demand, information asymmetry, perverse financial incentives for providers, and a culture of “more is better than less.” In fact, medical specialty societies participating in the Choosing Wisely® campaign have collectively published more than 400 tests and treatments they claim are overused or unnecessary. Initiatives created by organizations such as the American College of Physicians, the American College of Radiology, and the American Society of Clinical Oncology also attempt to stem the tide of overuse in their respective specialties and eliminate inappropriate care.
While there is a growing recognition that more care doesn’t equate to better outcomes, we lack a consensus on our path forward. We face challenges and gaps in our knowledge such as the lack of a common definition of overuse, identification of outcomes that are important to patients, and a complete understanding of the current evidence base.
To help close these gaps and develop a coordinated approach to research in this area, AcademyHealth and the ABIM Foundation have joined to create the Research Community on Low-Value Care to bring together researchers from across the health care system to achieve common goals critical in reducing low-value care:
- Facilitate information-sharing, communication and coordination among researchers with an interest in reducing overuse;
- Identify and characterize key challenges and priorities for strengthening research, practice and policy in reducing overuse;
- Help generate collaborations for extramurally funded research;
- Foster the exchange of innovative research methods and strategies for dissemination and implementation of research findings and lessons learned to end-user audiences; and,
- Cultivate opportunities for connection and collaboration with other stakeholders to increase awareness and uptake of research findings.
The Research Community on Low-Value Care builds on the outcomes of a multi-stakeholder meeting held in 2015 that sought to focus attention on the emerging and needed evidence base on overuse. Along with the Veterans Affairs Health Services Research and Development Service (HSR&D) , Kaiser Permanente and the Hartford Foundation for Public Giving, we convened clinicians, patients, researchers, health systems, purchasers and policy makers to help prioritize future research needs. That meeting also built on work in 2014 to identify the landscape of research currently underway on overuse and low value care. It is thanks to the learnings from participants in these activities over the last two years that the seeds of the research community were sown.
There is an increasing urgency to address issues of waste and overuse in our health care system. In order for the many various efforts to reduce low-value care realize their full potential, they must be evaluated and the results shared broadly. To support this learning and facilitate its dissemination, researchers and stakeholders will come together in this community to learn from each other and share tools, methods and new approaches. We are excited about the role this new community will play in developing a shared agenda and moving us along our path forward.
To join the learning community, please contact: RC-LVC@academyhealth.org.
President & CEO, AcademyHealth
|Daniel B. Wolfson
EVP & COO, ABIM Foundation